Full Name: Annie Johnson
Certificate Number: C-40071
Date of Death: January 17, 1911
Gender: Female
Race: Colored
Marital Status: S
Age at Death: about 55
Place of Birth: Maryland
Place of Death: Druid Hill Ave, 1516
Primary Cause of Death: Heart Failure
Father’s Name: Unsure
Mother’s Maiden Name: Unsure
Occupation: Cook
Date of Burial: 1/19/1911
Informant: Mary Brown, 1516 Druid Hill Ave
Undertaker: John A Bishop, 1107 Druid Hill Ave
Death Record Series ID: CM1132-108.xlsx
Notes: Prolonged Physical & Mental Stress
